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The foundation believes the federal deficit cannot be sustainably reduced without tackling its structural drivers, chief among them, runaway health-care costs. Medicare and Medicaid together account for roughly a quarter of the federal budget. If the U.S. reduced its health-care spending to Singaporean levels, the resulting savings, more than $1 trillion annually, could bring the deficit below 3% of GDP. With nominal GDP growing at over 4%, that shift would begin lowering the debt-to-GDP ratio, averting a potential fiscal crisis. While the Judah Spinner Foundation may eventually engage more directly on fiscal issues, its initial efforts will focus on lowering health-care costs, which would reduce the debt burden as a powerful secondary effect.